35
ine Listing Depa~t~veqi National Stock ExcAaage of lndia Itd hlurnbai 400 O5E. Scrip Code : SMALBV yhrehzgh : Rtt~s:,!Jk& i* COCO~'*~~CP?~S~~CO~,"PE~~ iPaGl Corporate Service Department BSE Limited Murnbai 400 001. Scrip Code: 54079 7 Through I http:r"/listing,bseindia.ccpi.n Sub: Investor Presepts:ron for the Thnrd qjarter & nine months ended 31 December, 2019 - Disclosure cinoer Regulataon 30 of SEBt jlistfng Obligations and Disclosure Requirements), Regu4atiasns, 2015 ('the 5EB1 LBDW"] Dear Sir / Madam, We are submitting berewith Enwestor Presentaxion on financial & operational performance of the Company 40s ~ P E Third quarter & Nine 3onths ended 34 December 2019, which is also being made available on our ~veiasite sn the investors section. LMe request to take IW Pame an your records and disseminate the same to the members. Thanking you, Yours sinceaeiy, For Sha4by Limited Compny Secretaw & Compliance Officer Mem. No: ACS14898 Eacl.: as above Shakby Limited Regd. Off. : a3p.p. Karwavat~ Club, 5 6; Road, Ahmedabad - 380015 (tndra'g TeL No. : (079) 4.3203000 1 Fax (079) 402.331~"3. I-shalby.org ( [email protected] Regd. No. : 061080596 1 CBN L8511QS32004PKai;r,667 Vapl- indore - lablpur - Mcshah - Navoi3a :Ahmedabad) Knshna Shabby (kfamedabadj Swat - ]alp&

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Page 1: No - Shalby Hospitals · 2 DISCLAIMER No representation or warranty, express or implied is made as to, and no reliance should be placed on, the fairness, accuracy, completeness or

i n e Listing D e p a ~ t ~ v e q i National Stock ExcAaage of lndia Itd hlurnbai 400 O5E.

Scrip Code : SMALBV

yhrehzgh : R t t ~ s : , ! J k & i * C O C O ~ ' * ~ ~ C P ? ~ S ~ ~ C O ~ , " P E ~ ~ iPaGl

Corporate Service Department BSE Limited Murnbai 400 001.

Scrip Code: 54079 7 Through I http:r"/listing,bseindia.ccpi.n

Sub: Investor Presepts:ron for t h e Thnrd q j a r t e r & nine months ended 31 December, 2019 - Disclosure cinoer Regulataon 30 of SEBt jlistfng Obligations and Disclosure Requirements), Regu4atiasns, 2015 ( ' the 5EB1 LBDW"]

Dear Sir / Madam,

W e are submitting berewith Enwestor Presentaxion on financial & operational performance of

t he Company 40s ~ P E Third quarter & Nine 3 o n t h s ended 34 December 2019, which is also

being made available on our ~veiasite sn the investors section.

LMe request to t ake IW Pame an your records and disseminate the s a m e to t h e members.

Thanking you,

Yours sinceaeiy, For Sha4by Limited

C o m p n y Secretaw & Compliance Officer Mem. No: ACS14898

Eacl.: a s above

Shakby Limited

Regd. Off. : a3p.p. Karwavat~ Club, 5 6; Road, Ahmedabad - 380015 (tndra'g TeL No. : (079) 4.3203000 1 Fax (079) 402.331~"3. I-shalby.org ( [email protected] Regd. No. : 061080596 1 CBN L8511QS32004PKai;r,667 Vapl- indore - l ab lpur - Mcshah - Navoi3a :Ahmedabad) Knshna Shabby (kfamedabadj Swat - ]alp&

Page 2: No - Shalby Hospitals · 2 DISCLAIMER No representation or warranty, express or implied is made as to, and no reliance should be placed on, the fairness, accuracy, completeness or

INVESTORPRESENTATION

Q3FY20

SHALBY LIMITED (BSE CODE: 540797 I SHALBY, NSE CODE: SHALBY)

A leader in Joint Replacement surgeries in India with an established chain of multi-specialty tertiary care hospitals.

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2www.shalby.org

DISCLAIMER

No representation or warranty, express or implied is made as to, and no reliance should be placed on, the fairness,

accuracy, completeness or correctness of such information or opinions contained herein. The information contained in

this presentation is only current as of its date. Certain statements made in this presentation may not be based on

historical information or facts and may be “forward looking statements”, including those relating to the Company’s

general business plans and strategy, its future financial condition and growth prospects, and future developments in its

industry and its competitive and regulatory environment. Actual results may differ materially from these forward-looking

statements due to a number of factors, including future changes or developments in the Company’s business, its

competitive environment and political, economic, legal and social conditions in India. This communication is for

general information purpose only, without regard to specific objectives, financial situations and needs of any particular

person. This presentation does not constitute an offer or invitation to purchase or subscribe for any shares in the

Company and neither any part of it shall form the basis of or be relied upon in connection with any contract or

commitment whatsoever. The Company may alter, modify or otherwise change in any manner the content of this

presentation, without obligation to notify any person of such revision or changes. This presentation can not be copied

and/or disseminated in any manner.

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3www.shalby.org

CONTENT

01 CORPORATE FACTS

02 OPERATIONAL PERFORMANCE

03 FINANCIAL PERFORMANCE

04 OTHER KEY UPDATES

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4www.shalby.org

RECENT RECOGNITION

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5www.shalby.org

CORPORATE FACTS

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6www.shalby.org

We value each and every

human life placed in our

hands and constantly work

towards meeting the

expectations of our

customers and stakeholders by raising the standards of

our service deliveries, every

time.

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7www.shalby.org

CORPORATE PHILOSOPHY

ELITE :OUR CORE VALUES

EXCELLNACE

LEARNING

INTEGRITY

TEAMWORK

EMPATHY

VISION MISSION

Exceeding expectation from health

Leveraging global leadership in Joint replacement to establish multi-specialty

care across geographies

We work with

an intent to

achieve

excellence in

whatever we

doWe continuously learn,

evolve & constantly look

for newer and more

efficient ways to achieve

our goals.

We always do the

right thing, even

when no one is

watching

We work

together for

one objective :

Patient

satisfaction

We do everything

possible for our

patient's well-

being, safety,

comfort &

happiness

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8www.shalby.org

Year 1994 2004 2007 2011 2015 2017 2019

▪ Started professionalpractice with a 6-bedfacility (Vijay Shalby)

▪ Revenue growth – 100 times in first 10 yearsIncorporation of Company

▪ Operationalized First Multi specialty Hospital of the group Shalby SG

▪ Acquired Shalby Vapi

▪ Acquired Krishna Shalby

▪ Bed capacity grown 10 times in 10 years – to 2012 beds. Commissioned:Shalby Jaipur Shalby NarodaShalby Surat

Shalby Mohali

▪ Went public through IPO on BSE & NSE.

▪ Commissioned Shalby Jabalpur

▪ Commissioned Shalby Indore

▪ Started implementation of advanced Hospital Information System (HIS) & SAP ERP

Key Milestones

6 27 228594

1070

2012 2012

Bed Capacity

1 1 24

6

11 11

# of Hospitals

HISTORIC EVOLUTION

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9www.shalby.org

11 60%Hospitals Operating bed to total bed capacity

2012 46%Total Bed Capacity Bed Occupancy (based on 985 census beds)

1200 31%Operational beds 12 year CAGR Revenue

3000+ 36% 12 year CAGR EBITDAHuman Resource (Doctor + Staff)

1500+ 32000+Surgeries per month Patients served per month

▪ Higher Double-digit return ratios against industry trend

▪ Consistently superior ROCE of mature hospitals

CORPORATE FACTS

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10www.shalby.org

ORGANISATION STRUCTURE

Group COO CFO CHRO CIO VP Projects

Chairman & Managing Director

DIRECTOR

CORPORATE SUB-FUNCTIONS

UNIT TEAMS

Unit CAO

Cluster COO

Corporate development

Clinical Applications

HR

Accounts

IT/Systems

Hospitality

Pharmacy

Billing

Quality

Admin/Operations/Eng.

Nursing

SCM

Radiology & Pathology

Unit CAO

➢ CORPORATE STRUCTURE ➢ UNIT LEVEL STRUCTURE

➢INTERNAL AUDITOR ➢STATUTORY AUDITOR

▪ PWC ▪ T R Chadha & Co LLP

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11www.shalby.org

EMINENT LEADERSHIP

Dr. Vikram ShahChairman & Managing Director

▪ MS Orthopaedics

▪ AO Basic Course (London)

▪ F.A.O.A.A (Switzerland)

▪ F.A.I.S.F (Germany)

KEY ACHIEVEMENTS:

▪ Over two and a half decades of professional work experience across

UK, USA and India. Serving as Director, Department of Knee

Replacement at Shalby Hospitals since 1993

▪ Dr. Shah innovated zero ‘0’ Technique in 2011 and was awarded the

Double Helical Award 2017, for the innovation

o Reduction of surgery time: 2.5 hours to 22 minutes

o Reduction in patient stay: 15 days to 3 days

o Drastic fall in infection rates due to minimum incision

▪ Invented the OS Needle, which is thick bore reverse cutting needle

used in attaching soft tissues to the bone. Before the invention of the

Needle, surgeons had to use complicated soft tissue procedures that

had a very high failure rate. The needle can be attached with

commonly available vicryl thread

▪ President of Indian Society of Hip & Knee Surgeons (ISHKS) for the

year 2010-11

▪ Part of joint international faculty for development of new joints by

Zimmer Inc., USA

▪ Receiver of several awards and accolades by reputed organizations

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12www.shalby.org

SHAREHOLDING PATTERN AS ON 31st DEC 2019

79.43%

7.72%

5.16%

4.71%

0.93%

0.77%

0.59%

0.31%

0.14%

0.24%

Promoter & Promoter Group

Resident Individuals

Foreign Portfolio Investors

Bodies Corporates

Employee Trust

Alternate Investment Funds

HUF

Non Resident Indians

Trust

Other

TOP 3 FIIs%

HOLDINGs

GOLDMAN SACHS INDIA LIMITED

3.01

KOTAK FUNDS - INDIA MIDCAP FUND

1.04

HSBC GLOBAL INVESTMENT FUNDS -INDIAN EQUITY

0.66

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13www.shalby.org

OUR PRESENCE

PUNJAB

▪ Mohali – 145 beds

RAJASTHAN

▪ Jaipur – 237 beds

GUJARAT

▪ Ahmedabado SG – 201 bedso Krishna – 220 beds

o Vijay – 27 bedsoNaroda – 267 beds

▪ Vapi – 146 beds

▪ Surat – 243 beds

MADHYA PRADESH

▪ Indore – 243 beds

▪ Jabalpur – 233 bedsMAHARASHTRA

▪ Mum (Ghatkoper) – 100 beds – Capex : Nil

▪ Mum (Santacruz) – 175 beds – Capex: INR 150Cr

▪ Nashik – 113 beds – Capex: INR 25Cr

➢ National Presence

➢Upcoming Units

Eldoret

Kisumu

Nairobi (1)Dar es Salaam (2)

Nairobi (1)

Addis Ababa (1)

Rwanda (1)

Sudan (1)

Kenya

Rwanda

Tanzania

Ethiopia

Sudan

➢ International Presence (in Africa)

Existing 11 Units (2012 beds)

MAHARASHTRA

▪ Ghatkoper (Zynova) – 50 beds

Upcoming 3 Units (388 beds) Network of 37 Outpatient Clinics across 11 states in India

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14www.shalby.org

OPERATIONAL PERFORMANCE

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15www.shalby.org

Particulars Q2 FY20 Q3 FY19 Q3 FY20Growth Q3 FY19

Vs Q3 FY20(%)

Total Revenue (INR million) 1278.79 1,151.13 1229.15 6.78%

Total EBITDA (INR million) 301.32 213.34 240.67 12.81%

EBITDA Margin (%) 23.56% 18.53% 19.58%

Bed Capacity (Nos.) 2012 2012 2012 -

Operational Beds (Nos.) 1200 1102 1200 8.89%

Average Length of Stay (without Daycare) 4.28 4.15 4.26 -

Occupancy (Beds) 473 397 456 14.86%

Occupancy (%) (based on operational beds) 39% 36% 38% -

In-Patient Count (Nos.) 10682 8796 9838 11.85%

Day-Care Patient Count (Nos.) 6726 4846 5701 17.64%

Out patient Count (Nos.) 83187 71738 80501 12.22%

Surgeries Count 4985 4638 4738 2.16%

ARPOB ( In Rs.) 29,399 31,517 29,299 -7.04%

Note: The operational bed count of 1,200 considers 36 operational beds at Zynova-Shalby Hospital, Mumbai, for which no other operational parameters are tracked

PERFORMANCE SYNOPSIS – Q3 FY 20

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2019 22083225

2330 2378

2619 2685

2921

2655 2360

Q3 FY19 Q4 FY19 Q1 FY20 Q2 FY20 Q3 FY20

Arthroplasty Other

7173877140

8757583187 80501

Q3 FY19 Q4 FY19 Q1 FY20 Q2 FY20 Q3 FY20

OP Count

8798 8672 9799 10682 9838

48446644

63566726

5701

Q3 FY19 Q4 FY19 Q1 FY20 Q2 FY20 Q3 FY20

IP Daycare

16www.shalby.org

1364215316

161554638

4893

6146

IP Count OP Count Surgeries Count

174084985

155394738

IP, OP, SURGERIES – QUARTERLY TREND

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17www.shalby.org

IP Count Day Care Count

OP Count Surgery Count

30522761 2722

263

3323

2830

3330

355

6+ Years 4-6 Years 2-4 Years <2 Years

IP Count Q3 - FY 19 IP Count Q3 - FY 20

625 504

3621

98

975612

4078

36

6+ Years 4-6 Years 2-4 Years <2 Years

Daycare Count Q3 - FY 19 Daycare Count Q3 - FY 20

2531

976 1026

105

2154

1131 1233

220

6+ Years 4-6 Years 2-4 Years <2 Years

Surgery Count Q3 - FY 19 Surgery Count Q3 - FY 20

IP, OP, SURGERIES – MATURITY WISE QUARTERLY TREND

*6 Years : SG, Krishna, Vijay & Vapi I 4-6 Years: Jabalpur, Indore I 2-4 Years: Surat, Naroda, Jaipur I <2 Years: Mohali

26955

2188718425

4471

33607

21503 21762

3962

6+ Years 4-6 Years 2-4 Years <2 Years

OP Count Q3 - FY 19 OP Count Q2 - FY 20

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18www.shalby.org

FINANCIAL PERFORMANCE

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213.34

240.67

Q3 FY19 Q3 FY20

31,517

29,299

Q3 FY19 Q3 FY20

4.154.26

Q3 FY19 Q3 FY20

128.90

82.82

Q3 FY19 Q3 FY20

113.47

Q3 FY19 Q3 FY20

1151.1

3

1229.1

5

Q3 FY19 Q3 FY20

19www.shalby.org

Revenue (INR Mn) EBITDA (INR Mn) PAT (INR Mn)

12.81%6.78%

ARPOB (INR/Day) ALOS (Excluding Daycare)

-7.04%

PBT (INR Mn)

22.59%

2.70%

35.75%

KEY FINANCIAL PARAMETERS – Q3 FY20

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20www.shalby.org

Particulars Q2 FY20 % of Revenue Q3 FY19 % of Revenue Q3 FY20 % of

Revenue

Growth Q3

FY19 Vs Q3

FY20(%)

Revenue from Operations 1258.33 1,129.67 1207.70 6.91%

Other Income 20.46 21.46 21.45 -0.05%

Total Income 1278.79 1,151.13 1229.15 6.78%

Expenses

Materials & Consumables 313.23 24.49% 298.48 25.93% 354.19 28.82% 18.67%

Fees to Doctors and Consultants 316.10 24.72% 310.99 27.02% 291.30 23.70% -6.33%

Other Operative Expenses 43.88 3.43% 35.35 3.07% 36.84 3.00% 4.21%

Employee Costs 209.68 16.40% 215.81 18.75% 207.28 16.86% -3.95%

Administrative Expenses 78.38 6.13% 58.69 5.10% 78.95 6.42% 34.50%

Advt. & Promotion 16.19 1.27% 18.47 1.60% 19.92 1.62% 7.85%

Total Operational Expenses 977.47 76.44% 937.79 81.47% 988.48 80.42% 5.41%

EBITDA 301.32 23.56% 213.34 18.53% 240.66 19.58% 12.81%

Finance Cost 10.46 14.64 13.04

Depreciation & Amortization Expense 91.56 85.23 88.53

Profit before tax (PBT) 199.30 113.47 139.10 22.59%

Tax Expense 70.33 -15.43 56.28

Profit after tax (PAT) 128.97 10.09% 128.90 11.20% 82.82 6.74% -35.75%

(Values in INR Mn)

FINANCIAL HIGHLIGHTS – Q3 FY 20

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44%

14%

6%

6%

3%3%

6%

18%Arthoplasty

Orthopaedic

Nephrology

General Surgery

Cosmetic & Plastic Surgery

Oncology

Cardiac Science

Others

63%

18%

15% 5%

Self Pay

Corporate Government

TPA

Corporate Private

43%

10%

12%

4%

5%

8%

7% 12%Arthoplasty

Cardiac Science

Critical Care & General Medicine

Nephrology

Neurology

Oncology

Other Ortho

Others

48%

12%

8%

8%

3%3%

3%16%

51%

25%

23% 2%

43%

10%

13%

4%

6%

9%

6% 11%

21www.shalby.org

Q3 FY19 Q3 FY20

Q3 FY19 Q3 FY20

Q3 FY19 Q3 FY20

SPECIALITY MIX (Revenue)

PAYERMIX (Revenue)

SURGERYMIX (Nos)

REVENUE MIX – Q3 FY19 Vs Q3 FY20

Note: Figures might not add up to 100% due to rounding off.

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# Parameters 6 Years+ 4-6 Years 2-4 Years <2 Years Total

1 Total Bed Capacity 594 476 747 145 1962

2 Operational Beds 382 361 275 34 1052

3 Avg. Occupied Beds 149 121 112 15 397

4 Occupancy ( % ) 39% 34% 41% 44% 36%

# Parameters 6 Years+ 4-6 Years 2-4 Years <2 Years Total

1 Revenue Share 50% 22% 25% 3% 100%

1A Arthoplasty 30% 4% 8% 1% 43%

1B Non-Arthoplasty 20% 18% 17% 2% 57%

2 EBITDA % 31.43% 9.36% 11.15% 1.58% 18.53%

3 ARPOB ( RS. ) 40,757 22,775 28,475 32,969 31517

4 ALOS ( DAYS ) 4.49 4.03 3.79 5.25 4.15

22www.shalby.org

➢OPERATIONAL PARAMETERS

Buckets Units

6+ Years Sg , Krishna , Vapi , Vijay

4-6 Years Jabalpur, Indore

2-4 Years Jaipur , Surat , Naroda

<2 Years Mohali

MATURITY PROFILE – Q3 FY19

➢FINANCIAL PARAMETERS

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# Parameters 6 Years+ 4-6 Years 2-4 Years <2 Years Total

1 Total Bed Capacity 613 488 766 145 2012

2 Operational Beds 437 330 324 73 1200*

3 Avg. Occupied Beds 158 139 142 17 456

4 Occupancy ( % ) 36% 42% 44% 23% 38%

# Parameters 6 Years+ 4-6 Years 2-4 Years <2 Years Total

1 Revenue Share 46% 23% 27% 4% 100%

1A Arthoplasty 29% 4% 9% 1% 43%

1B Non-Arthoplasty 18% 19% 18% 2% 57%

2 EBITDA % 31.87% 15.38% 16.09% -12.14% 19.58%

3 ARPOB ( RS. ) 39,193 21,403 25,761 31,455 29,299

4 ALOS ( DAYS ) 4.66 4.51 4.05 4.41 4.26

23www.shalby.org

➢OPERATIONAL PARAMETERS

Buckets Units

6+ Years Sg , Krishna , Vapi , Vijay

4-6 Years Jabalpur, Indore

2-4 Years Jaipur , Surat , Naroda

<2 Years Mohali

MATURITY PROFILE – Q3 FY20

➢FINANCIAL PARAMETERS

*In 1200, Zynova’s 36 operational beds have also been included

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24www.shalby.org

OTHER KEY UPDATES

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25www.shalby.org

CLINICAL HIGHLIGHTS

Amarnath Gupta, Chattisgarh

Surgery: Septic Arthritis of the left hip jointPatient was suffering from Septic Arthritis of left hip joint. He underwent many unsuccessful

treatments including incision & drainage. Patient was then treated under Dr. Vikram Shah

at Krishna Shalby. Since then, not only significant improvement has been seen but also he

has been able to keep well & happy.

Hari Kumar Sharma, Ahmedabad

Surgery: Knee ReplacementFollowing his wife’s successful bilateral knee replacement, the patient (aged 93) & his family

were surprised to witness the quite short & effective journey – right from surgery to the

recovery. Exceeding the expectations, as always.

Mansukh Patar, Gondal

Surgery: Kidney TransplantPatient was in a dire need of a solution to his kidney problems. Following multiple dialysis, he

was advised to go to Shalby, given its reputation in this domain. Dr. Kamal Goplani

successfully transplanted the kidney. Indeed, the patient is feeling better to get back to be

healthy again.

Sayali Yaul, Maharashtra

Surgery: Rheumatoid Arthritis6 years ago, the patient had started having pain in certain body parts including joints. After

consulting many doctors & undergoing Ayurvedic & Homeopathic treatments, she finally

met Dr. Vikram Shah & got her bilateral knee as well as hip replacements done successfully.

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26www.shalby.org

SHALBY ACADEMY

Ganpat University & Shalby Academy

MOU signed date – 22nd NOV, 2019

Shalby Signed off its academic partnership with Ganpat University in the presence of

Padmasree Ganpatbhai Patel (President and Patron of Ganpat University), Dr. Vikram Shah

(CMD Shalby Ltd) and Dr. Mahendra Sharma (Vice Chancellor) & Mr. Shanay Shah (Director)

UPES, Dehradun & Shalby Academy

MOU signed date – 13th DEC, 2019

Another milestone for the team. Shalby Academy signed an MOU with University of

Petroleum and Energy Studies (UPES) Dehradun to run Post Graduate Program in Healthcare

Management.

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27www.shalby.org

BUSINESS MODEL – FEATURES OPTIMISING CAPEX AND OPEX

Optimize capex

planning with

Inhouse projects

team

Utilities planning

to optimize

capex

Better utilization

of space [and

expensive real

estate]

Cost per bed ~

Rs. 3.5 millions

Operational

Efficiency due to

better capex

planning

Low consumable

cost

Leveraging

economies of

scale through

centralized

procurement

EBITDA upwards of

20% which is

higher than

industry average

▪Lowest Capex and Opex perbed due to optimal use ofreal-estate

▪Equipment planning andutilities planning

▪In-house planning teams

▪Focus on surgeries with higherARPOB, better margins andreturn ratios

▪Centralised procurement

▪Gradual ramp-up of bedcapacity

▪Fully owned or O&M onrevenue sharing (no fixedrentals, no security deposit orMG)

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28www.shalby.org

TYPICAL CONCEPT OF 200 (±20%) BED CAPACITY SET-UP

Facilities 10-15 kms away

Local and Natural Footfalls from 4-5 kms radius helps to fill up

~50% beds

Balance ~50% – patients come in the name of doctors

reducing thereby dependency on star doctors thus controlling

doctor payout %

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29www.shalby.org

OUR BUSINESS MODEL & GROWTH DRIVERS

Fully Owned

Hospital Manage-

mentContracts

Efficiency is paramount

Operate and

Manage [Revenue Sharing]

Huge scope for

organic growth and operating leverage

Pioneer in Joint

Replacements

in the country,

best positioned

to capitalize on

it

Continue to gain

traction within

Oncology and

Neurology

Increasing focus on quaternary

treatments like organ

transplants such as Liver, Heart,

Lungs and Kidney

Cardiac

Sciences, and

Critical Care

Opportunities

within Homecare

No fixed rental

No security deposit

No minimum

guarantee

Unique RevenueSharingModel

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30www.shalby.org

ROLE OF OPD FOR EXPANSION

Patients visit ourclinics across

India and abroad

We analyze patient trends and

accordingly decidewhere to expand

Simultaneously hire local doctors and train them at Ahmedabad who

conduct OPDs in and around

that citySo we can startthe facility withlow branding

budget but highbrand recall

Rajasthan

Madhya Pradesh

Gujarat

Maharashtra

Punjab

Ahmedabad

Set-up outpatient

clinics where we have a strong

brand recall

Operating such

Outpatient clinics

for 15 years now

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31www.shalby.org

SILVER LININGS IN THE HEALTHCARE SEGMENT

5.6% 6.0% 6.5% 6.7% 7.4% 8.6% 9.4%12.5%

19.4%

FY1961 FY1971 FY1981 FY1991 FY2001 FY2011 FY2017 FY2030E FY2050E

Percentage share of elderly population

Age > 60 yrs

23% 26% 28% 31% 35%

77% 74% 72% 69% 65%

1981 1991 2001 2011 2021E

India : Rising Urbanization

Rural

Urban

10 11 12 13 15

36 37 3844

65

France US Thailand Japan UK China Indonesia Malaysia Brazil India

Healthcare spendOut of the Pocket (OOP) component %

Source: Citi research, 2011 Census of India, *United Nations’ Forecast

Source: Citi Research, CRISIL

Source: UN World Urbanization Prospects

Global as well as Indian cues such as ever increasing % share of elderly population, favorable shift towards urbanization & rising OOP

healthcare spends – foster positive developments in the Indian Hospital space.

• Elderly population (60+ years) in India is expected to grow by 64% between 2015 and 2030 and the share of population over the age of 60 years is projected to increase from 9.4% in

2017 to 12.5% in 2030 and 20% in 2050 – more scope for already expanding healthcare services.

• Private healthcare players are well placed to benefit from rising urbanization and affluence levels.

• Higher out of the pocket spending, poor affordability and limited infrastructure are some of the key reason behind a low healthcare spending in India.

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Hence huge

potential for growth

based

on incidence rates

Asian

population

15 times more

prone to

Arthritis of knee

than their

western

counter parts

Last 1year,

In United States

~0.8 mn knee

replacements in a

population of

~300 mn

India has a similar

affording population.

Hence, direct

potential to grow to

8 lacs Knee

replacements

2010 ~54,000 surgeries2000

~6,000 surgeries

2017~1,75,000 surgeries

1994

~300

surgeries

1984 ~500

surgeries

1994 ~5000

surgeries

2004 ~ 50,000 surgeries

2014 ~ 2,00,000

surgeries and 8,00,000

Angioplasties

EMERGING MARKET TRENDS

The Cardiac Growth Story In India

Knee Replacement - The Big Opportunity

Wide procedure penetration –

to Tier 2 and 3 citiesCAGR – 29% in 30 years. Currently

growing @ 2-3%

Surgery Count CAGR @32% in 23 years

www.shalby.org 34

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33www.shalby.org

CONDUCIVE GOVERNMENT POLICIES DESPITE CHALLENGES

Wide procedure penetration –

to Tier 2 and 3 cities

Swastha Bharat, Smriddha Bharat. Demographic

dividend realization impossible without proper

healthcare

Rashtriya Samaj Beema Yojana: 100 million families will

get Rs 500,000 per year for their families to cover

secondary and tertiary hospital expenses

100% depreciation on capex incurred, MAT credit

can be availed for 15 years, all healthcare

education and training services exempted from

GST. GOI has proposed budget of Rs. 69,000 Cr. in

fiscal year 20-21 for Healthcare sector .

State Policies include capital subsidy on purchase of

medical equipment, capital investment subsidy on

construction of tertiary-care hospitals and interest

subvention, along with several other benefit

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THANK YOU

www.shalby.org

SHALBY LIMITED I Regd Off: Opp. Karnavati Club, S.G. Road, Ahmedabad – 380015, Gujarat, India. Phone: 079 4020 3000 Fax: +91 79 4020 3120 |

Website: www.shalby.org | CIN: L85110GJ2004PLC044667